Intrauterine balloon therapy: a novel ultrasound guided treatment for intrauterine adhesions

The diagnosis of intrauterine adhesions is becoming more frequent owing to widely available and accurate diagnostic modalities. However, despite numerous publications on this topic, little has been reported in terms of novel treatment techniques in the past couple of decades. In the present article, two carefully documented cases are presented, in which a novel technique for the treatment of intrauterine adhesions has been applied. The first case concerns a woman with severe intrauterine adhesions managed as an inpatient under general anaesthesia. The second case concerns a woman with a single intrauterine adhesion band managed in the outpatient clinic setting. In both cases, ultrasound guided intrauterine balloon (IUB) therapy was performed to resolve the adhesions. This involved dilating the uterine cavity under ultrasound guidance via use of a balloon in order to bluntly divide the adhesion bands along the weakest possible planes. Both cases were followed-up with 2D/3D saline infusion sonography (SIS) in the subsequent cycle, which confirmed successful treatment and absence of adhesion reformation. Our preliminary experience suggests that ultrasound guided IUB therapy may be a valuable addition to the current methods used for the treatment of intrauterine adhesions and may well deserve further investigation within the context of a clinical trial.